NPI | 1417206541 |
---|---|
Former Name | MISTY R. POOLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71009038A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007632) |
Enumeration Date | 2012-09-05 |
Last Update Date | 2023-08-01 |